SULC. FR.ORB. 'SULC. ORB.
From Cat. R.C.S. England.
a communication not only between the third and lateral ventricles, but between the two lateral ventricles, so that the cavity of each hemisphere is continuous with that of the other; soon, however, a median longitudinal fissure forms, into which the mesoderm grows to form the falx, and so the foramina of Munro are constricted into a V-shaped canal. In the floor of the hemispheres the corpora striata are developed at an early date by a multiplication of nerve cells, and on the external surface a depression, called the Sylvian fossa, marks the position of the future central lobe, which is after-wards hidden as the lips of the fossa (opercula) gradually close in on it to form the Sylvian fissure. The real fissures are complete infoldings of the whole thickness of the vesicular wall and produce swellings in the cavity. Some of them, like the choroidal on the mesial surface, are developed very early, while the vesicle is little more than epithelial, and contain between their walls an inpushing of mesoderm to form the choroid plexus. Others, like the hippocampal and calcarine, appear in the second and third months and correspond to invaginations of the nervous tissue, the hippocampus major and minor. The sulci appear later than the fissures and do not affect the internal cavity; they are due to the rapid growth of the cortex in certain areas. The corpus callosum and fornix appear about the third month and their development is somewhat doubtful; they are probably modifications of the lamina terminalis, but they may be secondary adhesions between the adjacent surfaces of the cerebral hemispheres where the cortical grey matter has not covered the white. They begin at their antero-ventral part near the genu of the corpus callosum and the anterior pillars of the fornix, and these are the parts which first appear in the lower mammals. The original anterior vesicle from which the hemispheres evaginate is composed, as already shown, of an anterior part or telencephalon and a posterior or thalamencephalon; the whole forming the third ventricle in the adult. Here the alar and basal laminae are both found, but the former is the more important; from it the optic thalami are derived, and more posteriorly the geniculate bodies. The anterior wall, of course, is the lamina terminalis, and from it are formed the lamina
cinerea, the corpus callosum, fornix and septum lucidum. The roof largely remains epithelial and is invaginated into the ventricle by the mesoderm to form the choroid plexuses of the third ventricle, but at the posterior part it develops the ganglia habenulae and the pineal body, from a structure just in front of which both a lens and retinal elements are derived in the lower forms. This is one great difference between the development of this organ and that of the true eyes; indeed it has been suggested that the pineal is an organ of thermal sense and not the remains of a median eye at all. The floor of the third ventricle is developed from the basal laminae, which here are not very important and from which the tuber cinereum and, until the fourth month, single corpus mammillare are developed, The infundibulum or stalk of the posterior part of the pituitary body at first grows down in front of the tuber cinereum and, according to Gaskel's theory, represents an ancestral mouth to which the ventricles of the brain and the central canal of the cord acted as the stomach and intestine (Quart. Journ. of Mic. Sci. 31, p. 379; and Journ. of Phys. v. to, p. 153). The reason why the basal lamina is here small is because it contains the nuclei of no cranial nerves. The anterior and posterior commissures appear before the middle ,and the middle before the corpus callosum, as they do in phylogeny. In connexion with the thalamencephalon, though not really belonging to it, may be mentioned the anterior lobes of the pituitary body; these begin as an upward diverticulum from the posterior wall of the primitive pharynx or stomatodaeum about the fourth week. This touch of Rathke, as it is called, becomes nipped off by the developing base of the skull, and its bifid blind end meets and becomes applied to the posterior part of the body, which comes down from the brain. In the mesencephalon the alar laminae form the corpora quadrigemina; these at first are bigeminal and hollow as they are in the lower vertebrates. The basal laminae thicken to form the crura cerebri. In the rhombencephalon the division into basal and alar laminae is better marked than in any other part; there is a definite groove inside the fourth ventricle, which remains in the adult as the superior and inferior fovea and which marks the separation between the two laminae. In the basal laminae are found the deep origins of most of the motor cranial nerves, while those of the sensory are situated in the alar laminae. The roof of the fourth ventricle widens out very much and remains largely epithelial as the superior and inferior medullary vela. The cerebellum develops in the anterior part of the roof of the rhombencephalon as two lateral rudiments which unite in the mid line and so form a transverse bar similar to that seen in the adult lamprey; at the end of the second month the flocculus and paraflocculus become marked, and later on a series of transverse fissures occur dividing the various lobes. Of the cerebellar peduncles the inferior develops first (third month), then the middle forming the pons (fourth month), and lastly the superior (fifth month) (Elliot Smith, Review of Neurology and Psychiatry, October 1903 ; W. Kuithan, " Die Entwicklung des Kleinhirns bei Saugetieren," Munchener Med. Abhandl., 1895; B. Stroud, " Mammalian cerebellum," Journ. of Comp. Neurology, 1895). Much of our knowledge of the tracts of fibres in the brain is due to the fact that they acquire their white sheaths at different stages of development, some long after birth.
For further details and references see Quain's Anat. vol. i. (1908) ; Minot's Human Embryology (New York) ; W. His, Anat. menschlicher Embryonen (Leipzig, 1881) ; Marshall's Vertebrate Embryology; Kolliker, Grundriss der Entwickelungsgeschichte (Leipzig, 188o) ; A. Keith, Human Embryology and Morphology (London, 19o4); 0. Hertwig, Handbuch der vergleichenden and experimentellen Entwickelungslehre der Wirbeltiere, Bd. 2, part 3 (Jena, 1902—1906); Development of the Human Body, J. P. McMurrich (1906).
(F. G. P.)
2. PHYSIOLOGY
The nervous system has as its function the co-ordinating of the activities of the organs one with another. It puts the organs into such mutual relation that the animal reacts as a whole with speed, accuracy and self-advantage, in response to the environmental agencies which stimulate it. For this office of the nervous system there are two fundamental conditions. The system must be thrown into action by agencies at work in the environment. Light, gravity, mechanical impacts, and so on, which are conditions significant for animal existence, must find the system responsive and through it evoke appropriate activity in the animal organs. And in fact there have been evolved in the animal a number of structures called receptive organs which are selectively excitable by different environmental agencies. Connected with these receptive organs lies that division of the nervous system which is termed afferent because it conducts impulses inwards towards the nervous centres. This division consists of elongates] norve-Cells, in man some two
(Anthropopithecus
4°4
million in number for each half of the body. These are living threads of microscopic tenuity, each extending from a receptive organ to a central nervous mass. These central nervous masses are in vertebrates all fused into one, of which the part which lies in the head is especially large and complex, because directly connected with particularly important and delicate receptive organs. The part of the central nervous organ which lies in the head has, in consequence of its connexion with the most important receptive organs, evolved a dominant importance in the nervous system, and this is especially true of the higher animal forms. This head part of the central nervous organ is sufficiently different from the rest, even to anatomical examination, to have received a separate name, the brain. But the fact of its having received a separate name ought not to obscure the singleness and solidarity of the whole central nervous organ as one entity. The functions of the whole central nervous organ from region to region are essentially similar throughout. One of its essential functions is reception, via afferent nerves, of nervous impulses generated in the receptive organs by environmental agents as stimuli. In other words, whatever the nature of the agent, its result on the receptive organs enters the central nervous organ as a nervous impulse, and all segments of the central nervous organ receive impulses so generated. Further, it is not known that nervous impulses present qualitative differences among themselves. It is with these impulses that the central nervous organ whether spinal cord or brain has to deal.
Material and Psychical Signs of Cerebral Activity.—In the central nervous organ the action resulting from entrant impulses has issue in three kinds of ways. The reaction may die out, be suppressed, and so far as discoverable lead to nothing; or the impulses may evoke effect in either or both of two forms. Just as from the receptive organs, nerves lead into the central nervous organ, so conversely from the central organ other nerves, termed efferent, lead to various organs of the body, especially glands and muscles. The reaction of the central nervous organ to impulses poured into it commonly leads to a discharge of impulses from it into glands and muscles. These centrifugal impulses are, so far as is known, qualitatively like the centripetal impulses. On reaching the glands and muscles they influence the activity of those organs. Since those organs are therefore the mechanisms in which the ultimate effect of the nervous reaction takes place, they are often termed from this point of view effector organs. A change ensuing in effector organs is often the only sign an observer has. that a nervous reaction has occurred, unless the nervous system under observation be the observer's own.
If the observer turns to his own nervous system for evidence of reaction, he meets at once in numberless instances with sensation as an outcome or sign of its reaction. This effect he cannot show to any being beside himself. He can only describe it, and in describing it he cannot strictly translate it into any term of material existence. The unbridged gulf between sensation and the changes produced in effector organs necessitates a separate handling of the functions of the nervous system according as their office under consideration is sensation or material effect. This holds especially in the case of the brain, and for the following reasons.
Psychosis and the Fore-Brain.—Hippocrates wrote, " It is through the brain that we become mad, that delirium seizes us, that fears and terrors assail us." " We know that pleasure and joy on the one hand and pain and grief on the other are referable to the brain. It is in virtue of it that we think, understand, see, hear, know ugliness and beauty, evil and good, the agreeable and the disagreeable." Similarly and more precisely Descartes indicated the brain, and the brain alone, as the seat of consciousness. Finally, it was Flourens who perhaps first definitely insisted on the restriction of the seat of consciousness in higher animals to that part of the brain which is the fore-brain. A functional distinction between the fore-brain and the remainder of the nervous system seems, in fact, that consciousness and physical reactions are adjunct to the fore-brain in a way in which they are not to the rest of the system. After transection of the[PHYSIOLOGY
spinal cord, or of the brain behind the fore-brain, psychical phenomena do not belong to the reactions of the nervous arcs posterior to the transection, whereas they do still accompany reactions of the nervous arcs in front and still connected with the fore-brain. A man after severance of the spinal cord does not possess in the strict sense consciousness of the limbs whose afferent nerves lie behind the place of spinal severance. He can see them with his eyes, and if the severance lie between the arms and the legs, can feel the latter with his hands. He knows them to be a part of his body. But they are detached from his consciousness. Sensations derived from them through all other channels of sense than their own do not suffice to restore them in any adequate measure to his consciousness. He must have the sensations so called " resident " in them, that, is, referred to them, without need of any logical inference. These can be yielded only by the receptive organs resident in the part itself, its skin, its joints, its muscles, &c., and can only be yielded by those receptive organs so long as the nerve impulses from them have access to the fore-brain. Consciousness, therefore, does not seem to attach to any portion of the nervous system of higher animals from which the fore-brain has been cut off. In the dog it has been found that no sign of memory, let alone intelligence, has been forthcoming after removal of the greater part of the fore-brain.
In lower vertebrates it is not clear that consciousness in primitive form requires always the co-operation of the fore-brain. In them the fore-brain does riot seem a conditio sine qua non for psychosis—so far as we may trust the rather hazardous inferences which study of the behaviour of fish, &c., allows. And the difference between higher and lowlier animal forms in respect of the fore-brain as a condition for psychosis becomes more marked when the Arthropoda are examined. The behaviour of some Insecta points strongly to their possessing memory, rudimentary in kind though it may be. But in them no homologue of the fore-brain of vertebrates can be indisputably made out. The head ganglia in these Invertebrates may, it is true, be analogous in function in certain ways to the brain of vertebrates. Some experiments, not plentiful, indicate that destruction of these head ganglia induces deterioration of behaviour such as follows loss of psychical functions in cases of destruction of the fore-brain in vertebrates. Though, therefore, we cannot be clear that the head ganglia of these Invertebrates are the same structure morphologically as the brain of vertebrates, they seem to hold a similar office, exercising analogous functions, including psychosis of a rudimentary kind. We can, therefore, speak of the head ganglia of Arthropods as a brain, and in doing so must remember that we define by physiological evidence rather than by morphological.
Cerebral Control over Lower Nervous Centres.—There accrues to the brain, especially to the fore-brain of higher Vertebrates, another function besides that of grafting psychical qualities upon the reactions of the nervous system. This function is exhibited as power to control in greater or less measure the pure reflexes enacted by the system. These pure reflexes have the character of fatality, in the sense that, given a particular stimulus, a particular reaction unvaryingly follows; the same group of muscles or the same gland is invariably thrown into action in the same way. Removal of the fore-brain, i.e. of that portion of the central nervous organ to which psychosis is adjunct, renders the nervous reactions of the animal more predictable and less variable. The animal, for instance, a dog, is given over more completely to simple reflexes. Its skin is touched and it scratches the spot, its jaw is stroked and it yawns, its rump is rubbed and it shakes itself, like a dog coming out of water; and these reactions occur fatally and inopportunely, for instance, when food is being offered to it, when the dog normally would allow no such insignificant skin stimuli as the above to defer his appropriate reaction. Goltz relates the behaviour of a dog from which almost the whole fore-brain had been removed. The animal lived healthily under the careful treatment accorded it. At feeding time a little quinine (bitter) added to its sop of meat and milk led to the morsels, after being taken into the
PHYSIOLOGY]
mouth, being at once and regularly rejected. None was ever swallowed, nor was the slightest hesitation in their rejection ever obtained by any coaxing or command, or encouragement of the animal by the attendant who constantly had charge of it. On the other hand, directly an undoctored piece had entered the mouth it was swallowed at once. Goltz threw to his own house-dog a piece of the same doctored meat. The creature wagged its tail and took it eagerly, then after receiving it into its mouth pulled a wry face and hesitated, astonished. But on encouragement to go on eating it the dog did so. Perhaps it deemed it unseemly to appear ungrateful to the giver and reject the gift. It overcame its reflex of rejection, and by its self-control gave proof of the intact cerebrum it possessed.
There seems a connexion between consciousness and the power to modify reflex action to meet the exigencies of the occasion. Pure reflexes are admirably adapted to certain ends. They are reactions which have long proved advantageous to the phylum of which the existent animal is the representative embodiment. But the reflexes have a machine-like fatality, and conscious aim does not forerun their execution. The subject as active agent does not direct them. Yet they lie under the control of higher centres. The cough, the eye-closure, the impluse to smile, all these can be suppressed. The innate respiratory rhythm can be modified to meet the requirements of vocal utterance. In other words, the reaction of reflex arcs is controllable by the mechanism to whose activity consciousness is adjunct. The reflexes controlled are often reactions but slightly affecting consciousness, but consciousness is very distinctly operative with the centres which exert the control. It may be that the primary aim, object and purpose of consciousness is control. " Consciousness in a mere automaton," writes Professor Lloyd Morgan, " is a useless and unnecessary epiphenomenon." As to how this conscious control is operative on reflexes, how it intrudes its influence on the running of the reflex machinery, little is known.
The Cerebrum an Organ giving Adaptation and Readjustment of Motor Acts.—The exercise of this control and the acquirement of skilled actions have obviously elements in common. By skilled actions, we understand actions not innately given, actions acquired by training in individual experience. The controlling centres pick out from an ancestral motor action some part, and isolate and enhance that until it becomes a skilled act. The motor co-ordination ancestrally provided for the ring finger gives an extending of it only in company with extension of the fingers on either side of it. The isolated lifting of the ring finger can, however, soon be acquired by training. In such cases the higher centre with conscious effort is able to dissociate a part from an ancestral co-ordination, and in that way to add a skilled adapted act to the powers of the individual.
The nervous organs of control form, therefore, a special instrument of adaptation and of readjustment of reaction, for better accommodation to requirements which may be new. The attainment of more precision and speed in the use of a tool, or the handling of a weapon, means a process in which nervous organs of control modify activities of reflex centres themselves already perfected ancestrally for other though kindred actions. This process of learning is accompanied by conscious effort. The effort consists not so much in any course of reasoning but rather in the acquiring of new sensorimotor experience. To learn swimming or skating by simple cogitation or mere visual observation is of course impossible. The new ideas requisite cannot be constructed without motor experience, and the training must include that motor experience. Hence the training for a new skilled motor manoeuvre must be simply ad hoc, and is of itself no training for another motor co-ordination.
The more complex an organism the more points of contact does it have with its environment, and the more does it need readjustment amid an environment of shifting relationships. Hence the organs of consciousness and control, being organs of adaptation and readjustment of reaction, will be more pronounced the farther the animal scale is followed upward to its crowning species, man. The cerebrum and especially the cerebral405
cortex may be regarded as the highest expression of the nervous organ of individual adaptation of reactions. Its high development in man makes him the most successful animal on earth's surface at the present epoch. The most important part of all this adjustment in his case, as he stands now, consists doubtless in that nervous activity which is intellectual. The mentality attached to his cerebrum includes reason in higher measure than is possessed by the mentality of other animals. He, therefore. more than they, can profitably forecast the future and act suitably to meet it from memory of the past. The cerebrum has proved itself by his case the most potent weapon existent for extending animal dominance over the environment.
Means and Present Aims of Physiological Study of the Brain.—The aspects of cerebral activity are therefore twofold. There is the contribution which it makes to the behaviour of the animal as seen in the creature's doings. On the other hand there is its product in the psychical life of the animal. The former of these is subject matter for physiology; the latter is especially the province of psychology. Physiology does, however, concern itself with the psychical aspect of cerebral functions. Its scope, embracing the study of the bodily organs in regard to function, includes the psychic as well as the material, because as just shown the former inextricably interlace with the latter. But the relation between the psychic phenomena and the working of the brain in regard to any data of fundamental or intimate character connecting the two remains practically as unknown to us as to the Greek philosophers. What physiology has at present to be content with in this respect is the mere assigning of certain kinds of psychic events to certain local regions of the cerebrum. This primitive quest constitutes the greater part of the " neurology " of our day, and some advance has been made along its lines. Yet how meagre are really significant facts will be clear from the brief survey that follows. Before passing finally from these general considerations, we may note that it becomes more and more clear that the brain, although an organ than can be treated as a whole, is complex in the sense that separable functions belong in some measure to its several parts.
The means principally adopted in studying the functions of the brain—and it must be remembered that this study in its present phase is almost exclusively a mere search for localization —are four. These are the physiological, the clinico-pathological, the histological and the zoological. The first named proceeds by observing the effects of artificial excitation, chiefly electric, of various parts of the brain, and the defects produced by destruction or removal of circumscribed portions. The clinicopathological proceeds by observing the disturbances of body and mind occurring in disease or injury, and ascertaining the extent of the disease or injury, for the most part post modem. The histological method examines the microscopic structure of the various regions of the brain and the characters and arrangement of the nerve-cells composing it. The zoological follows and compares the general features of the brain, as represented in the various types of animal creation.
It is on the functions of the fore-brain that interest now mainly focuses, for the reasons mentioned above. And the interest in the fore-brain itself chiefly attaches to the functions of its cortex. This is due to several causes. In man and the animals nearest him the cortex forms by far the larger part of the whole cerebral hemisphere. More than any other part it constitutes the distinctively human feature. It lies accessible to various experimental observations, as also to traumatic lesions and to the surgeon's art. It is composed of a great unbroken sheet of grey matter; for that reason it is a structure wherein processes of peculiar interest for the investigation in view are likely to occur. To make this last inference more clear a reference to the histology of nervous tissue must be made. The whole physiological function of the nervous system may be summed up in the one word " conduction." This " conduction " may be defined as the transmission of states of excitement (nerve-impulses) along the neural arcs composing the system. The whole nervous system is built up of chains of nerve-cells (neurones) which are nervous conductors, the chains often
4.06
being termed arcs. Each neurone is an elongated cell which transmits nerve-impulses from its one end to its other, without so far as is known modifying the impulses in transit, unless in that part of the nerve-cell where the nucleus lies. That part of the neurone or nerve-cell is called the perikaryon or cell-body, and from that part usually many branches of the cell (each branch being a nerve-fibre) ramify. There is no evidence that impulses are modified in transit along a branch of a nerve-cell, but there is clear evidence of manifold modification of nerve-impulses in transit along the nerve-arcs of the nervous system. These nerve-arcs are neurone-chains. In them one neurone continues the line of conduction where the immediately fore-going neurone left it. That is, the neurones are laid in conductive series, the far end of one apposed to the near end of its precursor. The place of juxtaposition of the end of one neurone against the beginning of another is called the synapse. At it the conduction which has so far been wholly intra-neuronic is replaced by an inter-neuronic process, in which the nerve impulse passes from one neurone to the next. The process there, it is natural to think, must be physiologically different from that conductive process that serves for transmission merely within the neurone itself. It may be that to this inter-neuronic conduction are due the differences between conduction in nerve-arcs and nerve-trunks (nerve-fibres) respectively. Significant of the former are changes in rhythm, intensity, excitability and modifications by summation and inhibition; in fact a number of the main features of nervous reaction. These characters impressed upon conduction in nerve arcs (neurone-chains) would therefore be traceable to the intercalation of perikarya and synapses, for both these structures are absent from nerve-trunks. It is therefore probably to perikarya and synapses that the greater part of the co-ordination, elaboration and differentiation of nervous reactions is due. Now, perikarya and synapses are not present in the white matter of the central nervous organ, any more than they are in nerve-trunks. They are confined exclusively to those portions of the central organ which consist of grey matter (so called from its naked-eye appearance). Hence it is to the great sheet of grey matter which enfolds the cerebrum that the physiologist turns, as to a field where he would expect to find evidences of the processes of cerebral co-ordination at work. It is therefore to items regarding the functions of the great sheet of cerebral cortex that we may now pass.
The Cerebral Cortex and its Functions.—The main question which vexed the study of the physiology of the cerebral hemispheres in the 19th century was whether differences of function are detectible in the different regions of the hemisphere and especially in those of its cortex. One camp of experimenters and observers held that the cortex was identical in function throughout its extent. These authorities taught that the various faculties and senses suffer damage in proportion to the amount of cortex removed or injured, and that it is a matter of indifference what may be the particular region wherein the destruction takes place. Against this an opposed set of observers held that different regions perform different functions, and this latter " differential " view was raised in two wholly dissimilar forms in the first and last quarters of the 19th century respectively. In the first quarter of the century, a school, with which the name of Gall is prominently associated, held that each faculty of a set of particular so-called " faculties," which it assumed constituted intelligence, has in the brain a spatially separate organ proper to itself. Gall's doctrine had two fundamental propositions. The first was that intelligence resides exclusively in the brain: the second, that intelligence consists of twenty-seven " faculties," each with a separate local seat in the brain. The first proposition was not new. It is met with in Hippocrates, and it had been elaborated by Descartes and others. But Bichat in his Anatomie generale had partly wandered from the gradually established truth and referred the emotions to the visceral organs, returning to a naive view popularly prevalent. Gall's first proposition was probably raised especially in reaction against Bichat. But Gall's proposition was retrograde from the true position of the science of his time. Flourens[PHYSIOLOGY
and others of his contemporaries had already shown not only that intelligence was resident exclusively in the brain, but that it was resident exclusively in that part of the brain which is the fore-brain. Now Gall placed certain of his twenty-seven intellectual faculties in the cerebellum, which is part of the hind-brain.
Phrenology.—As to Gall's second proposition, the set of faculties into which he analysed intelligence shows his power of psychological analysis to have been so weak that it is matter of surprise his doctrine could obtain even the ephemeral vogue it actually did. Among his twenty-seven faculties are, for instance, " l'amour de la progeniture, l'instinct carnassier, l'amitie, la ruse, la sagacite comparative, l'esprit metaphysique, le talent poetique, la mimique," &c. Such crudity of speculation is remarkable in one who had undoubtedly considerable insight into human character. Each of the twenty-seven faculties had its seat in a part of the brain, and that part of the brain was called its " organ." The mere spatial juxtaposition or remoteness of these organs one from another in the brain had, according to Gall, an influence on the constitution of the mind. " Comme l'organe des arts est place loin de l'organe du sens des couleurs, cette circonstance explique pourquoi les peintres d'histoire ont etc rarement coloristes." All these " faculty-organs " were placed by Gall at the surface of the brain. " This explains the correspondence which exists between craniology and the doctrine of the functions of the brain (cerebral physiology), the single aim of my researches." Gall wrote that he found the bump of pride (la bosse de l'orgueil) as far down in the animal series as the goat. Broussais traced the " organ " of veneration as far down as the sheep. Gall found the bump of murder (bosse du meurtre) in the carnivora. Later it was traced also in herbivora. Broussais added apologetically that " the herbivora cause a real destruction of plants."
Gall's doctrine enjoyed enormous vogue. He himself had the gifts and the demerits of quackery. His doctrine possessed, apart from its falsity, certain other mischievous qualities. " Que ces hommes si glorieux, qui font egorger les nations par millions, sachent qu'ils n'agissent point de leur propre chef, que c'est la nature qui a place clans leur cceur la rage de la destruction." One of his scientific opponents rejoined, " Nay, it is not that which they should know. What they should know is that if providence has allowed to man the possibility of doing evil, it has also endowed him with the power to do good." The main cause of the success of phrenology (q.v.) has been no doubt the common desire of men to read the characters and hidden thoughts of others by external signs. Each bump or "bosse " on the cranium was supposed to indicate the existence and degree of development of one or other of the twenty-seven " faculties." One such " bosse " showed the development of the organ of " goodness," and another the development of the organ of " murder." Such an easy means to arrive at information so curious delighted many persons, and they were not willingly undeceived.
Modern Localization Doctrines.—The crude localization of the phrenologists is therefore too clumsy to possess an interest it might otherwise have had as an early expression of belief in cerebral localization, a belief which other labours have subsequently justified, although on facts and lines quite different from these imagined by Gall'and his followers. Patient scientific toil by the hands of E. Hitzig and D. Ferrier and their followers has slowly succeeded in obtaining certain facts about the cortex cerebri which not only show that different regions of it are concerned with different functions, but, for some regions at least, outline to some extent the kind of function exercised. It is true that the greater part of the cortex remains still terra incognita unless we are content with'mere descriptive features concerning its coarse anatomy. For several scattered regions some knowledge of their function has been gained by physiological investigation. These scattered regions are the visual, the auditory, the olfactory and the precentral.
The grey matter of the cerebral cortex is broadly characterized histologically by the perikarya (nerve-cells bodies) which lie in it
PHYSIOLOGY)
possessing a special shape; they are pyramidal. The dendrite fibres of these cells—that is, their fibres which conduct towards the perikarya—are branches from the apex and corners of the pyramid. From the base often near its middle arises one large fibre—the axone fibre, which conducts impulses away from the perikaryon. The general appearance and arrangement of the neurones in a particle of cortical grey matter are shown in fig. 15, above. The apices of the pyramidal perikarya are turned towards the free surface of the cortex. The figure as interpreted in terms of functional conduction means that the cortex is beset with conductors, each of which collects nerve-impulses, from a minute but relatively wide field by its branched dendrites, and that these nerve-impulses converge through its perikaryon, issue by its axone, and are carried whithersoever the axone runs. In some few cells the axone breaks up into branches in the immediate neighbourhood of its own perikaryon in the cortex. In most cases, however, the axone runs off into the subjacent white matter, leaving the cortex altogether. On reaching the subjacent white matter it mingles with other fibres and takes one of the following courses:—(r) to the grey matter of the cortex of the same hemisphere, (2) to the grey matter of the cortex of the opposite hemisphere, (3) to the grey matter of the pons, (4) to the grey matter of the bulb or spinal cord. It is noteworthy that the dendrite fibres of these cortical neurones do not transgress the limits of the grey cortex and the immediate neighbour-hood of the perikaryon to which they belong; whereas the discharging or axone fibre does in the vast majority of cases transgress the limits of the grey matter wherein its perikaryon lies. The cortical neurone therefore collects impulses in the region of cortex just about its perikaryon and discharges them to other regions, some not cortical or even cerebral, but spinal, &c. One question which naturally arises is, do these cells spontaneously generate their impulses or are they stirred to activity by impulses which reach them from without? The tendency of physiology is to regard the actions of the cortex as reactions to impulses communicated to the cortical cells by nerve-channels reaching them from the sense organs. The neurone conductors in the cortex are in so far considered to resemble those of reflex centres, though their reactions are more variable and complex than in the use of the spinal. The chains of neurones passing through the cortex are more complex and connected with greater numbers of associate complex chains than are those of the spinal centres. But just as the reflex centres of the cord are each attached to afferent channels arriving from this or that receptive-organ, for instance, tactile-organs of the skin, or spindles of muscle-sense, &c., so the regions of cortex whose function is to-day with some certainty localized seem to be severally related each to some particular sense-organ. The localization, so far as ascertained, is a localization which attaches separate areas of cortex to the several species of sense, namely the visual, the auditory, the olfactory, and so on. This being so, we should expect to find the sensual representation in the cortex especially marked for the organs of the great distance-receptors, the organs which—considered as sense organs—initiate sensations having the quality of projicience into the sensible environment. The organs of distance-receptors are the olfactory, the visual and the auditory. The environmental agent which acts as stimulus in the case of the first named is chemical, in the second is radiant, and in the last is mechanical.
Olfactory Region of Cortex.—There is phylogenetic evidence that the development of the cortex cerebri first occurred in connexion with the distance-receptors for chemical stimuli—that is, expressed with reference to psychosis, in connexion with olfaction. The olfactory apparatus even in mammals still exhibits a neural architecture of primitive pattern. The cell which conducts impulses to the brain from the olfactory membrane in the nose resembles cells in the skin of the earthworm, in that its cell-body lies actually amid the epithelium of the skin-surface and is not deeply buried near or in the central nervous organ. Further, it has at its external end tiny hairlets such as occur in specially receptive-cells but not usually in purely nervous cells. Hence we must think that one and the same cell by its external end407
receives the environmental stimulus and by its deep end excites the central nervous organ. The cell under the stimulation of the environmental agent will therefore generate in itself a nervous impulse. This is the clearest instance we have of a neurone being actually excited under natural circumstances by an agent of the environment directly, not indirectly. The deep ends of these olfactory neurones having entered the central nervous organ come into contact with the dentrites of large neurones, called, from their shape, mitral. In the dog, an animal with high olfactory sense, the axone of each olfactory neurone is connected with five or six mitral cells. In man each olfactory neurone is connected with a single mitral cell only. We may suppose that the former arrangement conduces to intensification of the central reaction by summation. At the same time it is an arrangement which could tend to smother sharp differentiation of the central reaction in respect to locality of stimulus at the receptive surface. Considering the diffuse way in which olfactory stimuli are applied in comparison, for instance, with visual, the exact localization of the former can obviously yield little information of use for locating the exact position of their source. On the other hand, in the case of visual stimuli the locus of incidence, owing to the rectilinear propagation of light, can serve with extraordinary exactitude for inferences as to the position of their source. The adaptation of the neural connexions of the two organs in this respect is therefore in accord with expectation.
The earliest cerebral cortex is formed in connexion with the neurone-chains coming into the central nervous organ from the patch of olfactory cells on the surface of the head. The region of cerebrum thus developed is the so-called olfactory lobe and hippocampal formation. The greater part of the cerebral hemisphere is often termed the pallium, because as its development extends it folds cloak-wise over the older structures at the base of the brain. The olfactory lobe, from its position, is sometimes called the pallium basale, and the hippocampal formation the pallium marginale; and these two parts of the pallium form what, on account of their phylogenetic history, Elliott Smith well terms the archipallium. A fissure, the limbic fissure, marks off more or less distinctly this archipallium from the rest of the pallium, a remainder which is of later development and therefore designated by Elliott Smith the neopallium. Of the archipallium, the portion which constitutes the olfactory lobe is well formed in the selachian fish. In the reptilian cerebrum the hippocampal region, the palliu?n marginale, coexists in addition. These are both of them olfactory in function. Even so high up in the animal scale as the lowest mammals they still form one half of the entire pallium. But in the higher apes and in man the olfactory portion of the pallium is but a small fraction of the pallium as a whole. It is indeed so relatively dwarfed and obscured as to be invisible when the brain is regarded from the side or above. The olfactory part of the pallium exhibits little variation in form as traced up through the higher animals. It is of course small in such animals as Cetaceans, which are anosmatic. In highly osmatic such as the dog it is large. The uncus, and subiculum cornu ammonis of the human brain, belong to it. Disease of these parts has been accompanied by disturbance of the sense of smell. When stimulated electrically (in the rabbit) the olfactory pallium occasions peculiar torsion of the nose and lips (Ferrier), and change, often slowing or arrested, of the respiratory rhythm. P. E. Flechsig has shown that the nerve-fibres of this part of the pallium attain the final stage of their growth, that is to say, acquire their sheaths of myelin, early in the ontogenetic development of the brain. In the human brain they are myelinate before birth. This is significant from the point of view of function, for reasons which have been made clear especially by the researches of Flechsig himself.
The completion of the growth of the nerve-fibres entering and leaving the cortex occurs at very various periods in the growth of the brain. Study of the development of the fibres entering and leaving the various regions of the pallium in the human brain, discovers that the regions may be conveniently grouped into those whose fibres are perfected before birth and those whose fibres are perfected during the first post-natal month,
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and those whose fibres are perfected after the first but before the end of the fourth post-natal month. The regions thus marked out by completion before birth are five in number, and are each connected, as also shown by collateral evidence, with one or other particular species of sense-organ. And these regions have another character in common recognizable in the nerve-fibres entering and leaving them, namely, they possess fibres projected to or from parts of the nervous system altogether outside the cortex itself. These fibres are termed " projection " fibres. Other regions of the cortex possess fibres coming from or going to various regions of the cortex itself, but do not possess in addition, as do the five primitive cortical fields, the fibres of projection. So that the facts established by Flechsig for the regions of pallium, which other evidence already indicated as connected with the sense-organ of smell, support that evidence and bring the olfactory region of cortex into line with certain ether regions of cortex similarly primarily connected with organs of sense.
It will be noted that what has been achieved by these various means of study in regard to the region of the cortex to which olfactory functions are attributed amounts at present to little more than the bare ascertainment of the existence there of nervous mechanisms connected with olfaction, and to the de-limiting roughly of their extent and of their ability to influence certain movements, and in man sensations, habitually associated with exercise of the olfactory organ. As to what part the cortical mechanism has in the elaboration or association of mental processes to which olfaction contributes, no evidence worth the name seems as yet forthcoming. In this respect our knowledge, or rather our want of knowledge, of the functions of the olfactory region of the cortex, is fairly typical of that to which we have to confess in regard to the other regions of the cortex, even the best known.
Visual Region of the Cortex.—There is a region of the cortex especially connected with vision. The optic nerve and tract constitute the second link in the chain of neurones joining the retina to the brain. They may therefore be regarded as the equivalent of an intraspinal tract connecting the deep ends of the afferent neurones from the skin with higher nervous centres. In the bony fishes the optic tract reaches the grey matter of the optic lobe, a part of the mid-brain, to which the so-called anterior coliiculus is equivalent in the mammalian brain. In the optic lobe the axones of the neurones of the optic tract meet neurones whose axones pass in turn to the motor neurones of the muscles moving the eyeballs, and also to other motor neurones. But in these fish the optic tract has no obvious connexion with the fore-brain or with any cerebral pallium. Ascending, however, to the reptilian brain is found an additional arrangement: a small portion of the optic tract passes to grey matter in front of the optic lobe. This grey matter is the lateral geniculate body. From this geniculate body a number of neurones extend to the pallial portion of the cerebrum, for in the reptilian brain the pallium is present. The portion of pallium connected with the lateral geniculate body lies above and behind the olfactory or archipallium. It is a part of what was mentioned above as neopallium.
In the mammalian brain the portion of the optic tract which goes to the optic lobe (ant. colliculus of the mammal) is dwarfed by great development of the part which goes to the geniculate body and an adjoining grey mass, the pulvinar (part of the optic thalamus). From these latter pass large bands of fibres to the occipital region of the neopallium. In mammals this visual region of the cortex is distinguished in its microscopic features from the cortex elsewhere by a layer of myelinate nerve-fibres, many of which are the axones of neurones of the geniculate body and pulvinar. Thus, whereas in the bony fishes all the third links of the conductive chain from the retina lead exclusively to the final neurones of motor centres for muscles, in the mammal the majority of the third links conduct to grey matter of the cortex cerebri.
The application of electric stimuli to the surface of the cortex does not for the greater part of the extent of the cortex evoke[PHYSIOLOGY
in higher mammalian brains any obvious effect; no muscular act is provoked. But from certain limited regions of the cortex such stimulation does evoke muscular acts, and one of these regions is that to which the neurones forming the third link of the conductive chain from the retina pass. The muscular acts thus provoked from that region are movements of the eyeballs and of the neck turning the head. In the monkey the movement is the turning of both eyeballs and the head away from the side stimulated. In short, the gaze is directed as to an object on the opposite side. The newer conductive chain traceable through the cortex does therefore, after all, like the older one through the optic lobe, lead ultimately to the motor neurones of the eye muscles and the neck, only it takes a longer course thither and is undoubtedly much more complex. What gain is effected by this new and as it were alternative and longer route, which takes a path up to the cerebral cortex and down again, we can only conjecture, but of one point we may rest well assured, namely, that a much richer inter-connexion with other arcs of the nervous system is obtained by the path that passes via the cortex. The functional difference between the old conductive circuit and the new can at present hardly indeed be stated even in outline. A natural inference might be that the phylogenetically older and less complex path is concerned with functions purely reflex-motor, not possessing sensation as an attribute. But fish, which possess only the older path, can be trained to seize bait of one colour and not of another colour, even against what appeared to bean original colour-preference in them. Such discrimination individually acquired seems to involve memory, though it may be rudimentary in kind. Where motor reaction to visual stimuli appears to involve memory—and without memory the training could hardly be effective—some germ of consciousness can hardly be denied to the visual reactions, although the reactions occurred in complete absence of a cortical path and indeed of a visual cortex altogether.
Removal of the visual pallium in the tortoise produces little or no obvious defect in vision; but in the bird such a lesion greatly impairs the vision of the eye of the side opposite to the lesion. The impairment does not, however, amount to absolute blindness. Schrader's hawk, after removal of the pallium, reacted to movements of the mice with which it was caged. But the reactions were impaired: they lacked the sustained purpose of the normal reactions. The bird saw the mice; that was certain, for their movements across its field of vision made it turn its gaze towards them. But on their ceasing to move, the reaction on the part of the bird lapsed. Neither did their continuing to move excite the attack upon them which would have been the natural reaction on the part of the bird of prey towards its food. The bird apparently did not recognize them as prey, but saw them merely as moving objects. It saw them perhaps as things to which mental association gave no significance. Similarly, a dog after ablation of the occipital lobes of the cortex is able to see, for it avoids obstacles in its path; but if food is offered to it or the whip held up to it, it does not turn towards the food or away from the whip. It sees these things as if it saw them for the first time, but without curiosity, and as if it had no experience of their meaning. It gives no hint that it any longer understands the meaning of even familiar objects so long as these are presented to it through the sense of vision. Destruction of the visual cortex of one hemisphere alone produces in the dog impairment of vision, not as in the bird practically exclusively in the opposite eye, but in one lateral half of each eye, and that half the half opposite the hemisphere injured. Thus when the cortex destroyed is of the right cerebral hemisphere, the resultam visual defect is in the left half of the field of vision of both eyes. And this is so in man also.
In man disturbances of sensation can be better studied because it is possible to obtain from him his description of his condition. The relation of the cortex cerebri to human vision can be summarized briefly as follows. The visual cortex is dis. tinguishable in higher mammals by a thin white stripe, the stripe of Gennari, seen in its grey matter when that is sectioned. This stripe results from a layer of nerve-fibres, many of which are
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axones from the neurones of the lateral geniculate body and the pulvinar, the grey masses directly connected with the optic nerve-fibres. In the dog, and in such monkeys as the Macaque, the region of cortex containing this stripe traceable to optic fibres forms practically the whole occipital lobe. But in the man-like apes and in man this kind of cortex is confined to one region of the occipital lobe, namely, that of the calcarine fissure and the cuneus behind that. This region of cortex thus delimited in man is one of Flechsig's areas of earlier myelinization. It is also one of his areas possessing projection fibres; and this last fact agrees with the yielding by this area, when under electrical stimulation, of movements indicating that impulses have been discharged from it into the motor neurones of the muscles of the eyes and neck. Evidence from cases of disease show that destruction of the cortex of the upper lip of the calcarine fissure, say in the right half of the brain, causes in man impairment in the upper right-hand quadrant of both retinae: destruction of the lower lip of the fissure causes impairment in the lower right-hand quadrants. Destruction of the calcarine region of one hemisphere produces therefore "crossed hemianopia," that is, loss of the opposite half of the field of vision. But in this hemianopia the region of central vision is always spared. That is, the piece of visual field which corresponds with the yellow spot of the retina is not affected in either eye, unless the calcarine regions of both hemispheres are destroyed. This central point of vision is connected therefore not with one side of the brain only but with both.
The impairment of sight is more severe in men than in lower animals. Where the destruction of the visuo-sensory cortex in one calcarine region is complete, a candle-flame offered in the hemianopic field cannot even be perceived. It may hardly excite a reflex contraction of the pupil. In such cases the visual defect amounts to blindness. But this is a greater defect than is found in the dog even after entire removal of both occipital lobes. The dog still avoids obstacles as it walks. Its defect is rather, as said above, a complete loss of interest in the visual images of things. But a dog or monkey after loss of the visual cortex hesitates more and avoids obstacles less well in a familiar place than it does when entirely blind from loss of the peripheral organ of vision. In man extensive destruction of the visual cortex has as one of its symptoms loss of memory of localities, thus, of the paths of a garden, of the position of furniture, and of accustomed objects in the patient's own room. This loss of memory of position does not extend to spatial relations ordinarily appreciated by touch, such as parts of the patient's own person or clothing. There is nothing like this in the symptoms following blindness by loss of the eye itself. Those who lose their sight by disease of the retina retain good memorial pictures of positions and directions appreciated primarily by vision.
Cases of disease are on record in which loss of visual memory has occurred without hemianopia. Visual hallucinations referred to the hemianopic side have been observed. This suggests that the function of visual memory in regard to certain kinds of percepts must belong to localities of cortex different from those pertaining to other visual percepts. The area of cortex characterized by the stripe of Gennari occupies in man, as mentioned, the calcarine and cuneate region. It is surrounded by a cortical field which, though intimately connected with it by manifold conducting fibres, &c., is yet on various grounds distinct from it. This field of cortex surrounding the visuo-sensory of the calcarine-cuneate region is a far newer part of the neopallium than the region it surrounds. Both in the individual (Flechsig) and in the phylum (Bolton, Campbell, Mott) its development occurs far later than that of the visuo-sensory which. it surrounds. Flechsig finds that it has no " projection " fibres, that is, that it receives none of the optic radiations from the lower visual centres and gives no centrifugal fibres in the reverse direction. This field encompassing the visuo-sensory region differs from the latter in its microscopic structure by absence of the lower layer of stellate cells and by the presence in it of a third or deep layer of pyramidal cells (Mott). Its fibres are on the average smaller than are those of the visuo-sensory409
(W. A. Campbell). This zonal field is small in the lower apes, and hardly discoverable in the dog. In the anthropoid apes it is much larger. In man it is relatively much larger still. The impairment of visual memory and visual understanding in regard to direction and locality is said to be observed in man only when the injury of the cortex includes not only the calcarine-cuneate region but a wide area of the occipital lobe. From this it is argued that the zonal field is concerned with memories and recognitions of a kind based on visual perceptions. It has therefore been termed the visuo-psychic area. It is one of Flechsig's " association-areas " of the cortex.
Adjoining the antero-lateral border of the just-described visuo-psychic area lies another region separate from it and yet related to it. This area is even later in its course of development than is the visuo-psychic. It is one of Flechsig's " terminal fields," and its fibres are among the last to ripen in the whole cortex. This terminal field is large in man. It runs forward in the parietal lobe above and in the temporal lobe below. Its wide extent explains, in the opinion of Mott, the displacement of the visuo-sensory field from the outer aspect of the hemisphere in the lower monkeys to the median aspect in man. To this terminal field all the more interest attaches because it includes the angular gyrus, which authorities hold to be concerned with the visual memory of words. Study of diseased conditions of speech has shown that the power to understand written words may be lost or severely impaired although the words may be perfectly distinct to the sight and although the power to under-stand heard words remains good. This condition is asserted by many physicians to be referable to destruction of part of the angular gyrus. Close beneath the cortex of the angular gyrus runs a large tract of long fibres which pass from the visual cortex (see above) to the auditory cortex (see below) in the superior temporal gyrus and to the lower part of the frontal lobe. This lower part of the frontal lobe is believed—and has long been believed—to be concerned intimately with the production of the movements of speech. A difficulty besetting the investigation of the function of the angular gyrus is the fact that lesion of the cortex there is likely to implicate the underlying tract of fibres in its damage. It cannot be considered to have been as yet clearly ascertained whether the condition of want of recognition of seen words—" word-blindness "—is due to cortical injury apart from subcortical, to the angular gyrus itself apart from the underlying tract. Word-blindness seems, in the right-handed, to resemble the aphasia believed to be connected with the lower part of the frontal lobe, in that it ensues upon lesions of the left hemisphere, not of the right. In left-handed persons, on the contrary, it seems to attach to the right hemisphere.
Auditory Region of the Cortex.—Besides the two great organs of distance-receptors, namely, the nose and eye, whose cerebral apparatus for sensation has just been mentioned, those of a third great distance-receptor have to be considered. The agents of stimulation of the two former are respectively chemical (olfactory) and radiant (visual); the mode of stimulation of the third is mechanical, and the sensations obtained by it are termed auditory. Their cerebral localization is very imperfectly ascertained. Electric stimuli applied to a part of the uppermost temporal gyros excites movements of the ears and eyes in the dog. Destruction of the same region when executed on both hemispheres is argued by several observers to impair the sense of hearing. To this region of cortex fibres have been traced from the lower centres connected with the nerve-fibres coming from the cochlea of the ear. From each cochlear nerve a path has been traced which passes to the insulae and the above-mentioned temporal region of cortex of both the cerebral hemispheres. The insula is a deeper-seated area of cortex adjoining the upper-most temporal convolution. To it Flechsig's chronological studies also impute a connexion with the nerves of the ear. Early myelinization of fibres, presence of ascending and descending "projection" tracts to and from lower centres outside the cortex, calibre of fibres, microscopic characters of its cortical cells, all those kinds of indirect items of evidence that obtain
for the visual cortex likewise mark out this insular-temporal area as connected fairly directly with a special sense-organ, as in fact a sensory field of the cortex; and the suspicion is that it is auditory. Clinical observation supports the view in a striking way, but one requiring, in the opinion of some, further confirmation. It is widely believed that destruction of the upper and middle part of the uppermost temporal convolution produces " word-deafness," that is, an inability to recognize familiar words when heard, although the words are recognized when seen.
More precise information regarding this auditory region of the cortex has recently been obtained by the experiments of Kalischer. These show that after removal of this region from both sides of the brain in the dog the animal shows great defect in answering to the call of its master. Whereas prior to the operation the animal will prick its ears and attend at once to the lightest call, it requires after the removal of the auditory regions great loudness and insistence of calling to make it attend and react as it did. This is the more striking in view of other experimental results obtained. Kalischer trained a number of his dogs not to take meat offered them except at the sound of a particular note given by an organ pipe or a harmonium. The dogs rapidly learned not to take the food on the sounding of notes of other pitch than the one taught them as the per-missive signal. This reaction on the part of the animal was not impaired by the removal of the so-called auditory regions of the cortex. Kalischer suggests that this reaction taught by training is not destroyed by the operation which so greatly impairs the common reaction to the master's call, because the former is a simpler process more allied to reflex action. In it the attention of the dog is already fastened upon the object, namely the food, and the stimulus given by the note excites a reaction which simply allows the act of seizing the food to take place, or on the other hand stops it. In the case of answering the call of the master the stimulus has to excite attention, to produce perception of the locality whence it comes, and to invoke a complicated series of movements of response. He finds that destruction of the posterior colliculi of the mid-brain, which have long been known to be in some way connected with hearing, likewise destroys the response to the call of the master, but did not destroy the trick taught to his dogs of taking meat offered at the sound of a note of one particular pitch but not at notes of other pitch given by the same instrument.
Other Senses and Localization in the Cortex Cerebri.—Turning now to the connexion between the function of the cortex and the senses other than those of the great distance-receptors just dealt with, even less is known. Disturbance and impairment of skin sensations are observable both in experiments on the cerebrum of animals and in cases of cerebral disease in man. But the localization in the cortex of regions specially or mainly concerned with cutaneous sensation has not been made sufficiently clear to warrant statement here. Still less is there satisfactory knowledge regarding the existence of cortical areas concerned with sensations originated in the alimentary canal. The least equivocal of such evidence regards the sense of taste. There is some slight evidence of a connexion between this sense and a region of the hippocampal gyrus near to but behind that related to smell.
As to the sensations excited by the numerous receptors which lie not in any of the surface membranes of the body but embedded' in the masses of the organs and between them, the proprioceptors, buried in muscles, tendons and joints, there is little doubt that these sensations may be disturbed or impaired by injury of the cortex cerebri. They may probably also be excited by cortical stimulation. But evidence of localization of their seat in, and their details of connexion with, the cortex, is at present uncertain. Many authorities consider it probable that sensations of touch and the sensations initiated by the proprioceptors of muscles and joints (the organs of the so-called muscular sense) are specially related to the post-central gyrus and perhaps to the pre-central gyrus also. The clearest items on this point are perhaps the following.
Besides the regions instanced above, in the limbic (olfactory),
occipital (visual), and temporal (auditory) lobes, as exhibiting precocity of development, there is a region showing similar precocity in the fronto-parietal portion of the hemisphere. This is the region which in the Primates includes the large central fissure (sometimes called the fissure of Rolando). To it fibres are traced which seem to continue a path of conduction that began with afferent tracts belonging to the spinal cord, and tracts which there is reason to think conduct impulses from the receptor-organs of skin and muscles. The part of the cortex immediately behind the central fissure seems to be the main cortical goal for these upward-conducting paths. That post-central strip of cortex would in this view bear to these paths a relation similar to that which the occipital and temporal regions bear to afferent tracts from the retina and the cochlea. There are observations which associate impaired tactual sense and impaired perception of posture and movement of a limb with injury of the central region of the cortex. But there are a number also which show that the motor defect which is a well-ascertained result of injury of the pre-central gyrus is sometimes unaccompanied by any obvious defect either of touch or of muscular sense. It seems then that the motor centres of this region are closely connected with the centres for cutaneous and muscular sense, yet are not so closely interwoven with them that mechanical damage inflicted on the one of necessity heavily damages the other as well. There is evidence that the sensory cortex in this region lies posterior to that which has been conveniently termed the " motor." These latter in the monkey and the man-like apes and man lie in front of the central fissure: the sensory lie probably behind it. A. W. Campbell has found changes in the cortex of the post-central convolution ensuing in the essentially sensory disease, tabes dorsalis, a disease in which degeneration of sensory nerve-fibres of the muscular sense and of the skin senses is prominent. He considers that in man and the man-like apes the part of the post-central gyrus which lies next to and enters into the central fissure is concerned with simpler sensual recognitions, while the adjoining part of that convolution farther back is a " psychic region " concerned with more complex psychosis connected with the senses of skin and muscle. His subdivision of the post-central gyrus is based on histological differences which he discovers between its anterior and its posterior parts and on the above-described analogous differentiation of a " sensory " from a " psychic " part in the visual region of cortex.
It will be noted that although certain regions of the cortex are found connected closely with certain of the main sense organs, there are important receptive organs which do not appear to have any special region of cortex assigned to their sensual products. Thus, there is the " vestibular labyrinth " of the ear. This great receptive organ, so closely connected in function with the movements and adjustment of the postures of the head and eyes, and indeed of the whole body, is prominent in the co-ordination necessary for the equilibrium of the body, an essential part of the fundamental acts of progression, standing, &c. Yet neither structural nor functional connexion with any special region of the cortex has been traced as yet for the labyrinthine receptors. Perceptions of the position of the head and of the body are of course part of our habitual and everyday experience. It may perhaps be that these perceptions are almost entirely obtained through sense organs which are not labyrinthine, but visual, muscular, tactual, and so on. The labyrinth may, though it controls and adjusts the muscular activities which maintain the balance of the body, operate reflexly without in its operation exciting of itself sensations. The results of the unconscious reflexes it initiated and guided would be perceptible through other organs of sense. But against this purely unconscious functioning of the labyrinth and its nervous apparatus stands the fact that galvanic stimulation of the labyrinth is accompanied by well-known distinctive sensations—including giddiness, &c. More-over, the prominent factor in sea-sickness, a disorder richly suffused with sensations, is probably the labyrinth. Yet there is marked absence of evidence of any special and direct connexion between the cortex cerebri and the labyrinth organs.
Also there is curiously little evidence of connexion of the cortex
with the nervous paths of conduction concerned with pain. As far as the present writer can find from reference to books and from the clinical experience of others, " pain " is unknown as an aura in cortical epilepsy, or at most is of equivocal occurrence.
The preceding brief exposition of some of the main features of the localization of function in the cortex cerebri, gradually deciphered by patient inquiry, shows that the scheme of partition of function so far perceptible does not follow the quaint lines of analysis of the phrenologists with their supposed mental entities, so-called " faculties." On the contrary it is based, as some of those who early favoured a differential arrangement of function in the cerebrum had surmised, on the separateness of the incoming channels from peripheral organs of sense. These organs fall into groups separate one from another not only by reason of their spatial differentiation at the surface and in the thickness of the body, but also because each group generates sensations which introspection tells us are of a species unbridgeably separate from those generated by the other groups. Between sensations of hearing and sensations of sight there is a dissimilarity across which no intermediate series of sensual phenomena extend. The two species of sensations are wholly disparate. Simi-
larly there is a total and impassable gap between sensations of touch and sensations of sight and sound. In other words the sensations fall into groups which are wholly disparate and are hence termed species. But within each species there exist multifold varieties of the specific sensation, e.g. sensations of red, of yellow, &c. We should expect, therefore, that the conducting paths from the receptive organs which in their function as sense-organs yield wholly disparate sensations would in so far as subserving sensation diverge and pass to separate neural mechanisms. That these sense-organs should in fact be found to possess in the cortex of the cerebrum separate fields for their sensual nervous apparatus is, therefore, in harmony with what would be the a priori supposition.
But, as emphasized at the beginning of this article, the receptive organs belonging to the surfaces and the depths of the body and forming the starting-points for the whole system of the afferent nerves, have two functions more or less separate. One of these functions is to excite sensations and the other is to excite movements, by reflex action, especially in glands and muscles. In this latter function, namely the reflexifacient, all that the receptive organs effect is effected by means of the efferent nerves. They all have to use the efferent, especially the motor, nerves of
the body. So rich is the connexion of the receptive organs with the efferent nerves that it is not improbable that, through the central nervous organ, each receptive organ is connected with every motor nerve of the whole nervous system,—the facts of strychnine poisoning show that if this is not literally true it is at least approximately so. Hence one of the goals to which each afferent fibre from a receptive organ leads is a number of motor nerves. Their conducting paths must, therefore, con-verge in passing to the starting-points of the motor nerves; because these latter are instruments common to the use of a number of different receptive organs in so far as they excite reflex actions. On the other hand those of their conducting paths which are concerned in the genesis of sensation, instead of converging, diverge, at least as far as the cortex cerebri, or if not divergent, remain separate. These considerations would make it appear likely that the conducting path from each receptive organ divides in the central nervous system into two main lines, one of which goes off to its own particular region of the cortex cerebri whither run conductors only of similar sensual species to itself, while the other main line passes with many others to a great motor station where, as at a telephone exchange, co-ordinate use of the outgoing lines is assured to them all. Now there is in fact a portion of the cortex in mammals the functions of which are so pre-eminently motor, as judged by our present methods, that it is commonly designated the motor cortex (see
fig. 24). This region of the cortex occupies in the Primates, including Man, the pre-central gyrus. Among the items of evidence which reveal its motor capabilities are the following.
The Precentral or Motor Region of the Cortex.—The application to it of electric currents excites movements in the skeletal muscles. The movements occur in the half of the body of the side crossed from that of the hemisphere excited. The " motor representation," as it is termed, is in the cortex better described as a representation of definite actions than of particular muscles. The actions " represented " in the top part of the gyrus, namely next the great longitudinal fissure, move the leg; those in the lowest part of the gyrus belong to the tongue and mouth. The topical distribution along the length of the gyrus may be de-scribed in a general way as following a sequence resembling that of the motor representation in the spinal cord, the top of the gyrus being taken as corresponding with the caudal end of the spinal cord. The sequence as the gyrus is followed downwards runs: perineum, foot, knee, hip, abdomen, chest, shoulder, elbow, wrist, hand, eyelids and ear, nose, mouth and tongue. The nature of the movement is very fairly constant for separate
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points of this motor cortex as observed both in the same and in similar experiments. Thus flexion of the arm will be excitable from one set of points, and extension of the arm from another set of points; opening of the jaw from one set and closure from another, and so on. These various movements if excited strongly tend to have characters like those of the movements seen in an epileptic convulsion. Strong stimulation excites in fact a convulsion like that of epilepsy, beginning with the movement usual for the point stimulated and spreading so as to assume the proportions of a convulsion affecting the entire skeletal musculature of one half or even of the whole body. The resemblance to an epileptic seizure is the closer because the movement before it subsides becomes clonic (rhythmic) as in epilepsy. The determination of the exact spots of cortex in which are represented the various movements of the body has served a useful practical purpose in indicating the particular places in the cortex which are the seat of disease. These the physician can localize more exactly by reason of this knowledge. Hence the surgeon, if the nature of the disease is such as can be dealt with by surgical means, can without unnecessarily damaging the skull and brain, proceed directly to the point which is the seat of the mischief.
The motor representation of certain parts of the body is much more liberal than is that of others. There is little correspondence between the mere mass of musculature involved and the area of the cortex devoted to its representation. Variety of movement
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rather than force or energy of movement seems to demand extent of cortex. The cortical area for the thumb is larger than those for the whole abdomen and chest combined. The cortical area for the tongue is larger than that for the neck. Different movements of one and the same part are very unequally represented in the cortex. Thus, flexion of the leg is more extensively represented than is extension, opening of the jaw has a much larger cortical area than has closure of the jaws. It is interesting that certain agents, for instance strychnine, and the poison of the bacilli which cause the disease known as tetanus or lock-jaw, upset this normal topography, and replace in the cortex flexion of the limb by extension of the limb, and opening of the jaw by closure of the jaw. There is, however, no evidence that they do this by changing in any way the cortical mechanisms themselves. It is more likely that their action is confined to the lower centres, bulbar and spinal, upon which the discharge excited from the cortex plays. The change thus induced in the movement ex-cited by the cortex does, however, show that the point of cortex which causes for instance opening of the mouth is connected with the motor nerves to the closing muscles as well as with those of the opening muscles. This is an item of evidence that the " centres " of the cortex are connected with the motor nerves of antagonistic muscles in such a way that when the " centre " excites one set of the muscles to contract, it simultaneously under normal circumstances causes inhibition of the motor neurones of the opposed set of muscles (reciprocal innervation). In the great majority of movements excited from the motor cortex of a single hemisphere of the cerebrum, the movement evoked is confined to one side of the body, namely to that opposite to the hemisphere stimulated. There are, however, important exceptions to this. Thus, adduction of both vocal cords is excited from the cortex of either hemisphere. The movement of closure of the eyelids is usually bilateral, unless the stimulation be very weak; then the movement is of the eyelids of the opposite side only. The same holds true for the movements of the jaw. It, therefore, seems clear that with many movements which are usually bilaterally performed in ordinary life, such as opening of the jaw, blinking, &c., the symmetrical areas of the motor regions of both hemispheres are simultaneously in action.
In regard to all these movements elicitable by artificial stimuli from the motor cortex it is obvious that were there clearer evidence that the pallial region from which they are elicitable is fairly directly connected with corticopetal paths subserving cutaneous sensation or " muscular sense," the movements might be regarded as falling into the category of higher reflexes connected with the organs of touch, muscular sense, &c., just as the movements of the eyeball excitable from the visual cortex may be regarded as higher reflexes connected with vision. The evidence of the connexion of the reactions of the motor cortex with cutaneous and muscular senses appears, however, scarcely sufficient to countenance at present this otherwise plausible view, which has on general grounds much to commend it.
It is remarkable that movements of the eyeball itself, i.e. apart from movement of the lids, are not in the category of movements elicitable from the precentral gyms, the " motor " cortex. They are found represented in a region farther forward, namely in front of the precentral gyrus altogether, and occupying a scattered set of points in the direction frontal from the areas for movements of arm and face. This frontal area yields on excitation conjugate movements of both eyeballs extremely like if not exactly similar to those yielded by excitation of the occipital (visual) region of the cortex. It is supposed by some that this frontal area yielding eye-movements has its function in this respect based upon afferent conductors from other parts of the eyeball than the retina, for instance upon kinaesthetic (Bastian) impressions or upon sensual impressions derived from the cornea and the coats of the eyeball including the ciliary and iris muscles. The ocular muscles are certainly a source of centripetal impulses, but their connexion with the cortex is not clear as to either their nature or their seat. The question seems for the present to allow no clearer answer. It is certain, however, that the frontal area of eye movements has corticofugal paths[PHYSIOLOGY
descending from it to the lower motor centres of the eyeballs quite independent of those descending from the occipital (visual) area of eye-movements. Further, it seems clear that in many animals there is another cortical region, a third region, the region which we saw above might be considered auditory, where movements of the eyeball similar to those elicitable in the occipital and frontal cortex can be provoked. A. Tschermak is inclined to give the eyeball movements of the frontal region the significance of reflex movements which carry the visual field in various directions in answer to demands made by sensory data derived from touch, &c., as for instance from the hand. The movements of the eyeballs elicitable from the occipital region of the cortex he regards as probably concerned with directing the gaze toward something seen, for instance, in the peripheral field of vision. The occipital movement would, therefore, be excited through the retina, and would result in bringing the yellow spot region of the retinae of both eyes to bear upon the object. This view has much to justify it. The movements of the eyeballs excited from the cortex of the auditory region would in a similar way be explicable as bringing the gaze to bear upon a direction in which a sound had been located, auditory initiation replacing the visual and tactual of the occipital and the frontal regions respectively.
Turning from these still speculative matters to others less suggestive but of actual ascertainment, we find that the motor nature of the precentral cortex as ascertained by electric stimuli is further certified by the occurrence of disturbance and impairment of motor power and adjustment following destruction of that region of the cortex. The movements which such a part as a limb executes are of course manifold in purpose. The hind limb of a dog is used for standing, for stepping, for scratching, for squatting, and, where a dog, for instance, has been trained to stand or walk on its hind legs alone, for skilled acts requiring a special training for their acquisition. It is found that when the motor area of the brain has been destroyed, the limb is at first paralysed for all these movements, but after a time the limb recovers the ability to execute some of them, though not all. The scratching movement suffers little, and rapid improvement after cerebral injury soon effaces the impairment, at first some-what pronounced, in the use of the limb for walking, running, &c., and ordinary movements of progression. Even when both hemispheres have been destroyed the dog can still stand and walk and run. Destruction of the motor region of the cortex renders the fore limbs of the dog unable to execute such skilled movements as the steadying of a bone for gnawing or the trained act of offering the paw in answer to the command of the master. Skilled acts of the limb, apart from conjoined movements in which it, together with all the other limbs, takes part, assume of course a larger share of the office of the limb in the Primates than in the dog; and this is especially true for the fore limb. It is when the fore-foot becomes a hand that opportunity is given for its more skilled individual use and for its training in movements as a tool, or for the handling of tools and weapons. It is these movements which suffer most heavily and for the longest period after injury of the motor region of the cortex. Hence the disablement ensuing upon injury to the cortex would be expected to be most apparent in the Primates; and it is so, and most of all in Man. Further, in Man there ensues a condition called " contracture," which is not so apparent or frequent a result in other animals,—indeed, does not occur at all in other animals except the monkey. In contracture the muscles of the paretic limb are not flaccid, as they are usually in paralysis, but they are tense and the limb is more or less rigidly fixed by them in a certain position, usually one of flexion at elbow and wrist. This condition does not occur at first, but gradually supervenes in the course of a number of weeks. In Man the destruction of the motor area of the cortex cripples the limb even for the part it should play in the combined limb movements of walking, &c., and cripples it to an extent markedly contrasting with the slight disturbances seen in the lower mammals, e.g. the dog.
As regards the recovery of motor power after lesions of the
motor cortex, two processes seem at work which are termed respectively restitution and compensation. By the former is understood the recovery obtained when a part of a " centre " is destroyed, and the rest of the centre, although thrown out of function at first, recovers and supplements the deficiency later. An example of restitution would be the recovery from temporary hemianopia caused by a small injury in one occipital lobe. By compensation is understood the improvement of an impaired nervous function, traceable to other centres different from those destroyed supplying means to compass the reaction originally dependent on the centres subsequently destroyed. Instances of such compensation are the recovery of taxis for equilibrium subsequent to destruction of the labyrinth of the ear, where the recovery is traceable to assistance obtained through the eye. It will be noted that these instances of recovery by restitution and by compensation respectively are taken from cases of injury inflicted on receptive rather than on motor centres. It is doubtful how far they really apply to the undoubted improvement that does within certain limits progress and succeed in partially effacing the paresis immediately consequent on lesions of the motor area. It has to be remembered that in all cases of traumatic injury to the nervous system, especially where the trauma implicates the central nervous organ, the first effects and impairment of function resulting are due to a mixed cause, namely on the one hand the mechanical rupture of conducting paths actually broken by solution of their continuity, and on the other hand the temporary interruption of conducting paths by " shock." Shock effects are not permanent: they pass off. They are supposed to be due to a change at the synapses connecting neurone with neurone in the grey matter. They amount in effect to a long-lasting and gradually subsiding inhibition.
For diseases of the brain see NEUROPATHOLOGY, INSANITY, SKULL (Surgery), &c. (C. S. S.)